USF-COM
Department
of Family Medicine
Patient Education Information on...
Index of
Patient Education Topics
What
is osteoporosis ?
Osteoporosis is a disease that
gradually weakens bones, leading to bone fragility. The amount of calcium
in bones slowly decreases making the bones less dense and strong. If not
prevented or if left untreated, osteoporosis can progress painlessly until
a bone breaks. Hence, there is more risk of fractures of the hip, spine,
and wrist.
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Facts
you should know
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Osteoporosis, the gradual loss
of skeletal bone mineral over time, begins as early as 30 - 35 years old.
It results in 1.5 million fractures each year. It is more common than diabetes,
stroke, and heart disease combined.
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The first sign of this "silent
killer" may be a hip or wrist fracture, significant back pain, or a loss
of height.
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A woman’s likelihood of developing
osteoporosis increases with age.
-
About 40% of all women will
have at least one spinal fracture by 80 years of age. Vertebral fractures
often heal unevenly leaving the individual bent over with a curved back
or "dowager’s hump"
-
Help
Preserve Your Independence -- Talk to your doctor about osteoporosis today!
-
Understand
what osteoporosis is and what steps you can take to prevent or treat it
-
Learn
about Osteoporosis:
-
What are the signs?
-
Am I at risk?
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What causes it?
-
What are the tests?
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How can I prevent it?
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What are the treatments?
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What
causes Osteoporosis ?
The cause of osteoporosis is
not known.
The following are factors
or circumstances that are known to contribute to the development of this
disease:
-
diet (especially calcium intake)
-
exercise
-
heredity
-
hormones (particularly the female
sex hormone estrogen)
-
intestinal and kidney function
-
overall health
-
medical conditions and their
treatments
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Why
is it important ?
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It is a disease that can be
prevented and treated.
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Osteoporosis is a major public
health threat for 28 million Americans, 80% of whom are women
-
10 million Americans already
have osteoporosis
-
1 of every 2 women and 1 of
8 men over 50 years old will have an osteoporosis-related fracture in their
lifetime
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Who
is at greatest risk ?
The reason so many women are
affected is that menopause is the major risk factor for the disease. The
following factors add to postmenopausal risk, but even if you have none
of these risk factors, it is still possible that you have osteoporosis.
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Early menopause (before age
45)
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Caucasian race or Asian ethnicity
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Thin, small build
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Anorexia
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Chronic use of steroids, excessive
thyroid hormone, certain anticonvulsant medications
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Family history of osteoporosis
or fractures
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Lifestyle factors: inactivity,
excessive caffeine consumption, smoking, excess alcohol
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Are
there any tests for Osteoporosis ?
BMD (Bone Mineral Density) is
used to describe the amount of calcium in your skeleton. Bone density changes
with age. There are several methods for taking this measurement. The most
common is DEXA. It is the most accurate, most advanced, and low radiation
of the tests. There is no injection and it takes 5-15 minutes to perform.
Who
can get DEXA ?
DEXA is generally performed
on postmenopausal women with two or more major risk factors. It is also
used in evaluation and monitoring of treatment programs for osteoporosis.
At present, mass screening for osteoporosis is not warranted.
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What
are the medications to treat and prevent osteoporosis ?
New
therapeutic advances offer effective intervention to treat osteoporosis
and lower fracture risk
The key to managing osteoporosis
is to prevent as much bone loss as possible with a healthful diet and exercise.
However there are medications to treat and prevent osteoporosis:
Fosomax
(alendronate): builds healthy bone, reduces the risk of spinal fractures
by nearly half and decreases the resulting loss of height in postmenopausal
women. At high doses causes gastrointestinal side effects.
Miacalcin,
Calcimar (calcitonin): slows down annual bone loss rate. Side effects
include nausea and/or vomiting, anorexia, diarrhea, skin reashes, and swollen
feet. Some users develop resistance or allergic reactions after longterm
use. And nasal sprays may cause nose bleeds or sinusitis.
Evista
(raloxifene): Newest for the prevention of osteoporosis in postmenopausal
women. Mimics estrogen’s beneficial effect on bone and cholesterol without
negative effects on the breast or uterus. Side effects are increased risk
of leg clots, hot flashes, and leg cramps
Estrogen:
prevents the accelerated postmenopausal calcium depletion and reduces the
risk of fracture. Risk of blood clots, breast cancer, and endometrial cancer
if used alone
Fluoride:
low doses beneficial. Side effects include nausea and gastric irritation
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How
can Osteoporosis be prevented ?
Building strong bones, especially
before the age of 35, can be the best defense against developing osteoporosis.
A healthy lifestyle is also important for keeping bones strong. To prevent
osteoporosis:
-
Eat a balanced diet rich in
calcium (>1000 mg per day for ages 19-50 and >1200 mg per day for postmenopausal
women)
-
Exercise regularly, especially
weight-bearing activities
-
Don’t smoke, limit caffeine
and alcohol intake
-
Talk to your doctor if there
is a family history of osteoporosis or if you are postmenopausal
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References: